The Cardiovascular System

Prepared by: Arthur Christian B.

Mangio PTRP
The workhorse of the cardiovascular system.
Propels blood through the 50,000 miles of blood vessels in the
body.
Beats approximately 100,00 times everyday

THE HEART
• Cardiology
• The heart beats about 100,000 times every
day, which adds up to about 35 million beats
in a year, and approximately 2.5 billion times
in an average lifetime
• The workhorse of the cardiovascular system.
• Propels blood through the 50,000 miles of
blood vessels in the body.
 Anatomy
• The heart is a relatively small, roughly the
same size (but not the same shape) as your
closed fist
• It is about 12 cm (5 in.) long, 9 cm (3.5 in.)
wide at its broadest point, and 6 cm (2.5 in.)
thick,
• 250 g (8 oz) - adult females
• 300 g (10 oz) - adult males.
• Shaped like a blunt cone
• The heart rests on the diaphragm, near the midline of
the thoracic cavity
• It lies in the mediastinum , an anatomical region that
extends from the sternum to the vertebral column, from
the first rib to the diaphragm, and between the lungs
• Slanted diagonally with 2/3 of the mass lies to the left of
the body’s midline
• The pointed apex is formed by the tip of the left ventricle
(a lower chamber of the heart) and rests on the
diaphragm.
– It is directed anteriorly, inferiorly, and to the left
• The base of the heart is opposite the apex and is its
posterior aspect.
– It is formed by the atria (upper chambers) of the heart, mostly
• Heart surfaces
– The anterior surface is deep to the sternum and
ribs
– The inferior surface is the part of the heart
between the apex and right surface and rests
mostly on the diaphragm
– The right surface faces the right lung and extends
from the inferior surface to the base.
– The left surface faces the left lung and extends
from the base to the apex
 The Pericardium
• The membrane that surrounds and protects the heart
• It confines the heart to its position in the mediastinum,
while allowing sufficient freedom of movement for
vigorous and rapid contraction
• Consists of two main parts
• The superficial fibrous pericardium is composed of tough,
inelastic, dense irregular connective tissue.
– The fibrous pericardium prevents overstretching of the heart,
provides protection, and anchors the heart in the mediastinum.
– The fibrous pericardium near the apex of the heart is partially
fused to the central tendon of the diaphragm and therefore
movement of the diaphragm, as in deep breathing, facilitates
the movement of blood by the heart.
• The deeper serous pericardium is a thinner, more delicate
membrane that forms a double layer around the heart
– The outer parietal layer of the serous pericardium is fused to the
fibrous pericardium.
– The inner visceral layer of the serous pericardium, which is also called
the epicardium, is one of the layers of the heart wall and adheres tightly
to the surface of the heart.
• Between the parietal and visceral layers of the serous
pericardium is a thin film of lubricating serous fluid
• This slippery secretion of the pericardial cells, known as
pericardial fluid, reduces friction between the layers of the
serous pericardium as the heart moves
• The space that contains the few milliliters of pericardial fluid is
called the pericardial cavity.

 Pericarditis - Inflammation of the pericardium, results in a

decrease in the amount of pericardial fluid
 Layers of the Heart Wall
• Consists of three layers
• The epicardium is composed of two tissue layers. The
outermost, is called the visceral layer of the serous
pericardium.
– This thin, transparent outer layer of the heart wall is composed of
mesothelium
– The epicardium imparts a smooth, slippery texture to the outermost
surface of the heart.
– The epicardium contains blood vessels, lymphatics, and vessels that
supply the myocardium
• The middle myocardium (mī′-ō-KAR-dē-um; myo- = muscle) is
responsible for the pumping action of the heart and is
composed of cardiac muscle tissue.
• The innermost endocardium (en′-dō-KAR-dē-um;
endo- = within) is a thin layer of endothelium
overlying a thin layer of connective tissue.
– It provides a smooth lining for the chambers of the
heart and covers the valves of the heart
– The smooth endothelial lining minimizes the surface
friction as blood passes through the heart.
– The endocardium is continuous with the endothelial
lining of the large blood vessels attached to the heart.
 The Chambers Of The Heart
• The heart has four chambers
• The two superior receiving chambers are the atria
• The two inferior pumping chambers are the ventricles
• On the anterior surface of each atrium is a wrinkled pouchlike
structure called an auricle so named because of its resemblance to a
dog’s ear
– Each auricle slightly increases the capacity of an atrium so that it can hold a
greater volume of blood
• Also on the surface of the heart are a series of grooves, called sulci,
that contain coronary blood vessels and a variable amount of fat
– Each sulcus marks the external boundary between two chambers of the
heart.
• The deep coronary sulcus (coron- = resembling a crown) encircles
most of the heart and marks the external boundary between the
superior atria and inferior ventricles
• The anterior interventricular sulcus is a shallow
groove on the anterior surface of the heart that
marks the external boundary between the right and
left ventricles on the anterior aspect of the heart.
• This sulcus continues around to the posterior surface
of the heart as the posterior interventricular sulcus,
which marks the external boundary between the
ventricles on the posterior aspect of the heart

• The paired atria receive blood from blood vessels

returning blood to the heart, called veins, while the
ventricles eject the blood from the heart into blood
vessels called arteries.
• Right atrium - forms the right surface of the heart and receives blood
from three veins: the superior vena cava, inferior vena cava, and
coronary sinus
• The right atrium is about 2–3 mm (0.08–0.12 in.) in average thickness.
• The inside of the posterior wall is smooth
• The inside of the anterior wall is rough due to the presence of muscular
ridges called pectinate muscles which also extend into the auricle
• Between the right atrium and left atrium is a thin partition called the
interatrial septum (inter- = between; septum = a dividing wall or
partition)
• Fossa ovalis - the remnant of the foramen ovale, an opening in the
interatrial septum of the fetal heart that normally closes soon after birth
• Blood passes from the right atrium into the right ventricle through a
valve that is called the tricuspid valve because it consists of three cusps
or leaflets
– It is also called the right atrioventricular valve .
• The valves of the heart are composed of dense connective tissue
covered by endocardium.
• Right ventricle - about 4–5 mm (0.16–0.2 in.) in average
thickness and forms most of the anterior surface of the heart
• The inside of the right ventricle contains a series of ridges
formed by raised bundles of cardiac muscle fibers called
trabeculae carneae
• The cusps of the tricuspid valve are connected to tendonlike
cords, the chordae tendineae which in turn are connected to
cone-shaped trabeculae carneae called papillary muscles
• Internally, the right ventricle is separated from the left
ventricle by a partition called the interventricular septum.
• Blood passes from the right ventricle through the pulmonary
valve (pulmonary semilunar valve) into a large artery called
the pulmonary trunk, which divides into right and left
pulmonary arteries and carries blood to the lungs.
• Left atrium - about the same thickness as the right
atrium and forms most of the base of the heart
• It receives blood from the lungs through four
pulmonary veins.
• The posterior and anterior wall is smooth
• Blood passes from the left atrium into the left
ventricle through the bicuspid (mitral) valve which,
as its name implies, has two cusps
• The term mitral refers to the resemblance of the
bicuspid valve to a bishop’s miter (hat), which is
two-sided. It is also called the left atrioventricular
valve
• Left ventricle - the thickest chamber of the heart,
averaging 10–15 mm (0.4–0.6 in.), and forms the apex of
the heart
• Contains trabeculae carneae and has chordae tendineae
that anchor the cusps of the bicuspid valve to papillary
muscles
• Blood passes from the left ventricle through the aortic
valve (aortic semilunar valve) into the ascending aorta
• Some of the blood in the aorta flows into the coronary
arteries
• The remainder of the blood passes into the arch of the
aorta and descending aorta (thoracic aorta and
abdominal aorta)
• Branches of the arch of the aorta and descending aorta
• During fetal life, a temporary blood vessel,
called the ductus arteriosus, shunts blood
from the pulmonary trunk into the aorta.
• Hence, only a small amount of blood enters
the nonfunctioning fetal lungs.
• The ductus arteriosus normally closes shortly
after birth, leaving a remnant known as the
ligamentum arteriosum which connects the
arch of the aorta and pulmonary trunk
HEART VALVES AND THE
CIRCULATION OF THE HEART
 Atrioventricular Valves
[AV VALVES]
• Tricuspid and Bicuspid valves
• Located in between an atrium and ventricle
• When an AV valve is open, the rounded ends of the cusps project
into the ventricle.
• When the ventricles are relaxed, the papillary muscles are relaxed,
the chordae tendineae are slack, and blood moves from a higher
pressure in the atria to a lower pressure in the ventricles through
open AV valves
• At the same time, the papillary muscles contract, which pulls on and
tightens the chordae tendineae. This prevents the valve cusps from
everting (opening into the atria) in response to the high ventricular
pressure. \
• If the AV valves or chordae tendineae are damaged, blood may
 Semilunar Valves
• Aortic and pulmonary valves
• The SL valves allow ejection of blood from the heart into
arteries but prevent backflow of blood into the ventricles
• When the ventricles contract, pressure builds up within the
chambers.
• The semilunar valves open when pressure in the ventricles
exceeds the pressure in the arteries, permitting ejection of
blood from the ventricles into the pulmonary trunk and aorta
• As the ventricles relax, blood starts to flow back toward the
heart
• This backflowing blood fills the valve cusps, which causes the
free edges of the semilunar valves to contact each other
tightly and close the opening between the ventricle and artery
Systemic and Pulmonic Circulation
 Authorhytmic Fibers
The Conduction System
• An inherent and rhythmical electrical activity is the
reason for the heart’s lifelong beat
• The source of this electrical activity is a network of
specialized cardiac muscle fibers called
autorhythmic fibers because they are self-excitable.
• Autorhythmic fibers repeatedly generate action
potentials that trigger heart contractions.
• They continue to stimulate a heart to beat even
after it is removed from the body
 Conduction system
• Sinoatrial node – main pacemaker of the heart
• Atrioventricular node
• Atrioventricular bundle or the bundle of His
• Purkinjie fiber
Action Potential
Electrocardiogram
• As action potentials propagate through the heart, they
generate electrical currents that can be detected at the
surface of the body.
• An electrocardiogram , abbreviated either ECG or EKG
(from the German word Elektrokardiogram), is a
recording of these electrical signals.
• The ECG is a composite record of action potentials
produced by all of the heart muscle fibers during each
heartbeat.
• The instrument used to record the changes is an
electrocardiograph.
• Analysis of an ECG also involves measuring the time spans
• P–Q interval is the time from the beginning of the P wave to
the beginning of the QRS complex.
– It represents the conduction time from the beginning of atrial
excitation to the beginning of ventricular excitation
• S–T segment, which begins at the end of the S wave and ends
at the beginning of the T wave, represents the time when the
ventricular contractile fibers are depolarized during the plateau
phase of the action potential
– The S–T segment is elevated (above the baseline) in acute
myocardial infarction and depressed (below the baseline) when the
heart muscle receives insufficient oxygen.
• The Q–T interval extends from the start of the QRS complex to
the end of the T wave.
– It is the time from the beginning of ventricular depolarization to the
end of ventricular repolarization.
– The Q–T interval may be lengthened by myocardial damage,
myocardial ischemia (decreased blood flow), or conduction
 The Cardiac Cycle
• A carefully regulated sequence of steps that we think as the beating
of the heart
• Systole – the contraction of atria and ventricles
• Diastole – relaxation
• 4 stages
1. during atrial systole,, both atria contract forcing blood into the
ventricles
2. During ventricular systole[0.3 sec], both ventricles contract forcing
blood out of the pulmonary artery and aorta
3. During atrial diastole [0.7 sec], the ventricles remain contracted and
the atria begin refilling from the large veins leading to the heart from
the body
4. Ventricular diastole [0.5 sec], begins before atrial systole, allowing
the ventricles to fill with blood from the atria
 Heart Sounds
• Auscultation - the act of listening to sounds
within the body, is usually done with a
stethoscope.
• During each cardiac cycle, there are four heart
sounds, but in a normal heart only the first
and second heart sounds (S1 and S2) are loud
enough to be heard through a stethoscope
• The first sound (S1), which can be described as a lubb sound,
is louder and a bit longer than the second sound. S1 is caused
by blood turbulence associated with closure of the AV valves
soon after ventricular systole begins
• The second sound (S2), which is shorter and not as loud as
the first, can be described as a dupp sound. S2 is caused by
blood turbulence associated with closure of the SL valves at
the beginning of ventricular diastole.
• Although S1 and S2 are due to blood turbulence associated
with the closure of valves, they are best heard at the surface
of the chest in locations that are slightly different from the
locations of the valves
THE BLOOD VESSELS
 5 main types of blood vessels
• Arteries - carry blood away from the heart to
other organs. Large, elastic arteries leave the
heart and divide into medium-sized, muscular
arteries that branch out into the various
regions of the body
• Medium-sized arteries then divide into small
arteries, which in turn divide into still smaller
arteries called arterioles
• As the arterioles enter a tissue, they branch into
numerous tiny vessels called blood capillaries or simply
capillaries.
• The thin walls of capillaries allow the exchange of
substances between the blood and body tissues.
• Groups of capillaries within a tissue re - unite to form
small veins called venules .
• These in turn merge to form progressively larger blood
vessels called veins.
• Veins (VĀNZ) are the blood vessels that convey blood from
the tissues back to the heart.
 Basic Structure of a Blood Vessel
• Tunica Interna [intima]
– Forms the inner lining of a blood vessel and is in direct
contact with the blood as it flows through the lumen
• Tunica Media
– A muscular and connective tissue layer that displays the
greatest variation among the different vessel types
– In most vessels, it is a relatively thick layer comprising
mainly smooth muscle cells and substantial amounts of
elastic fibers.
– regulate the diameter of the lumen.
• Tunica Externa [adventitia]
– outer covering of a blood vessel
– consists of elastic and collagen fibers
– contains numerous nerves and,especially in larger vessels,
tiny blood vessels that supply the tissue of the vessel wall
– the tunica externa helps anchor the vessels to
surrounding tissues.

• Vasa vasorum – vessel to the vessels

– small vessels that supply blood to the tissues of the vessel
 Arteries
• The wall of an artery has the three layers of a
typical blood vessel, but has a thick muscular-
to-elastic tunica media
• Due to their plentiful elastic fibers, arteries
normally have high compliance, which means
that their walls stretch easily or expand
without tearing in response to a small increase
in pressure.
• Elastic arteries - the largest arteries in the body, ranging
from the garden hose–sized aorta and pulmonary trunk
to the finger-sized branches of the aorta
– have the largest diameter among arteries
– their vessel walls are relatively thin compared with the overall
size of the vessel
– They help propel blood onward while the ventricles are
relaxing. As blood is ejected from the heart into elastic
arteries, their walls stretch, easily accommodating the surge of
blood.
– As they stretch, the elastic fibers momentarily store
mechanical energy, functioning as a pressure reservoir. Then,
the elastic fibers recoil and convert stored (potential) energy in
the vessel into kinetic energy of the blood
– Because they conduct blood from the heart to mediumsized,
more muscular arteries, elastic arteries also are called
• Muscular arteries – medium sized arteries
– their tunica media contains more smooth muscle and
fewer elastic fibers than elastic arteries.
– capable of greater vasoconstriction and vasodilation to
adjust the rate of blood flow.
– span a range of sizes from the pencil-sized femoral and
axillary arteries to string-sized arteries that enter organs,
measuring as little as 0.5 mm (1∕64 inch) in diameter
– Because the muscular arteries continue to branch and
ultimately distribute blood to each of the various organs,
they are called distributing arteries

– vascular tone - The ability of the muscle to contract and

maintain a state of partial contraction
• stiffens the vessel wall and is important in maintaining vessel
• Anastomoses
– The union of the branches of two or more arteries
supplying the same body region
• Arterioles
– Abundant microscopic vessels that regulate the
flow of blood into the capillary networks of the
body’s tissues
 Capillaries
• The smallest of blood vessels, have diameters of 5– 10 μm,
and form the U-turns that connect the arterial outflow to
the venous return
• Form an extensive network, approximately 20 billion in
number, of short (hundreds nof micrometers in length),
branched, interconnecting vessels that course among the
individual cells of the body
• The primary function of capillaries is the exchange of
substances between the blood and interstitial fluid.
• Found near almost every cell in the body, but their number
varies with the metabolic activity of the tissue they serve.
• Exchange vessels.
 Venules
• Have thin walls that do not readily maintain their
shape.
• Venules drain the capillary blood and begin the
return flow of blood back toward the heart
• Postcapillary venules - venules that initially receive
blood from capillaries
– Smallest and very porous
– They function as significant sites of exchange of
nutrients and wastes and white blood cell emigration,
and for this reason form part of the microcirculatory
exchange unit along with the capillaries
• As the postcapillary venules move away from capillaries, they
acquire one or two layers of circularly arranged smooth
muscle cells.
• These muscular venules (50 μm to 200 μm) have thicker walls
across which exchanges with the interstitial fluid can no longer
occur.
• The thin walls of the postcapillary and muscular venules are
the most distensible elements of the vascular system; this
allows them to expand and serve as excellent reservoirs for
accumulating large volumes of blood.
• Blood volume increases of 360% have been measured in the
postcapillary and muscular venules.
 Veins
• Have very thin walls relative to their total diameter
• The tunica interna of veins is thinner than that of
arteries
• The tunica media of veins is much thinner than in
arteries, with relatively little smooth muscle and
elastic fibers.
• The tunica externa of veins is the thickest layer and
consists of collagen and elastic fibers
• Distensible enough to adapt to variations in the
volume and pressure of blood passing through them,
but are not designed to withstand high pressure.
• The lumen of a vein is larger than that of a
comparable artery, and veins oft en appear
collapsed (flattened) when sectioned.
• Many veins, especially those in the limbs, also
contain valves, thin folds of tunica interna that form
flaplike cusps. The valve cusps project into the
lumen, pointing toward the heart.
• The low blood pressure in veins allows blood
returning to the heart to slow and even back up; the
valves aid in venous return by preventing the
backflow of blood.
• Anastomotic veins
– double sets of veins that escort the arteries and
connect with one another via venous channels
– Cross the accompanying artery to form ladderlike
rungs between the paired veins
• Superficial vein –
• Deep veins that travel between the skeletal
muscles.
– These connections allow communication between
the deep and superficial flow of blood